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COVID 19 and diabetes: a lethal partnership? How do we overcome this?

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By Dr. Kayathri Periasamy

With the latest wave of COVID-19 infections sweeping steadily across Sri Lanka, attention has been directed towards persons with uncontrolled, pre-existing conditions, particularly diabetes; as a sect most vulnerable to get severely ill or die because of complications caused by the virus. This has shed light on another growing concern among healthcare providers and patients, which is that patients suffering from diabetes or other chronic conditions are finding it increasingly difficult or are unable to access the medical care they require due to mandatory albeit essential curfew measures combined with a deep fear of contracting the virus in communal healthcare settings.

With a staggering 463 million adult diabetic patients present worldwide, World Diabetes Day 2020 – falling on the 14th of November- is a critical time for diabetes support communities and healthcare advocates to rally together to create awareness about this debilitating medical condition and push for progress in the standards of care and the better management of diabetic patients during a pandemic. In Sri Lanka alone, 1 in 10 adults are approximated to suffer from the disease. It is also then vital to look at ways to help stop more people from getting this disease, particularly at a time when ‘lockdown’ lifestyles are more often than not likely to be sedentary, unhealthy and stressful; an ideal background for a diabetes diagnosis.

Why is uncontrolled diabetes such a potent accelerant for COVID-19?

A recent study conducted by Lancet on Diabetes & Endocrinology screened over 61 million medical records in the U.K. to find that 30% of COVID-19 deaths can be attributed to people with diabetes. After accounting for factors such as demography and chronic medical conditions, the risk of succumbing to the virus was shown to be about three times higher for people with Type 1 diabetes and almost twice as high for Type 2, versus those without the disease. 

There appears to be two primary reasons driving this predicament. Over a lifetime, poor glucose control inflicts widespread damage in our systems which can lead to strokes, heart attacks, kidney failure, eye disease, and limb amputations. The linings of blood vessels throughout the body weaken to an extent where they can’t ferry necessary nutrients adequately. Inflammation is another byproduct of poor diabetes control, which makes the body ill-prepared for the onslaught of the viral disease. Secondly, the rich environment of elevated blood glucose present in diabetic patients, makes them prone to superadded bacterial complications during the viral infection. Many diabetics also tend to have other co-morbidities such as obesity, hypertension, and heart disease, which are all factors that aggravate complications during viral illneses. These problems are seen in any infections in the setting of diabetes and not only with COVID 19. The pandemic has just highlighted the difficulties of having diabetes

 

What precautions can diabetic patients take?

So during this pandemic, apart from strict adherence to general COVID-19 personal safety protocols such as strict social distancing and sanitization, it is important for patients to regularly monitor their glucose levels to avoid complications caused by fluctuating blood glucose. Proper hydration is essential for good health. It is also crucial to have access to a good supply of the prescribed diabetes medications and healthy food so that patients are able to correct the situation if blood glucose levels fluctuate. Finally, sticking to a comfortable daily routine, maintaining an exercise program even within the confines of your home, reducing excessive work and having a good night’s sleep can go a long way in keeping you strong. In essence, maintaining good blood sugar levels may be their best defense against severe COVID-19.

Disruption to continuity of care for diabetes patients

A rapid assessment survey conducted by WHO among Ministries of Health across many countries, focusing on the service delivery for NCDs during the COVID-19 pandemic, revealed deepening concerns that many people living with NCDs are no longer receiving appropriate treatment or access to medicines during the COVID-19 pandemic. The more severe the transmission phase of the COVID-19 pandemic, the more NCD care services were disrupted.

With our country currently in the cluster transmission phase and heading towards the community transmission phase due to the large and distant spread of the first-line contacts, the threat to NCD care and especially routine and emergency care of diabetes patients worries us physicians. As healthcare providers, we too are torn between the dilemma of not wanting to expose our patients to unnecessary hospital visits and the need to ensure that all our patients have continued access to their healthcare team along with a steady supply of medicines and other diabetes care products such as glucometer strips and insulin. Unfortunately, the delay in visiting their healthcare provider when they have symptoms of complications has caused many people to present late to the hospital with heart attacks or infections. A delayed presentation, weakens the patient further.

This disruption to healthcare services is foreseen to be a huge dilemma for patients and healthcare providers alike, especially when it comes to the care of patients with diabetes and other non-communicable diseases. In Sri Lanka, the Ministry of Health, is currently providing a number of telemedicine services and has opened avenues to deliver medicines to houses without diabetic persons having to visit crowded settings

 

How do we counter this?

At Healthy Life Clinic, we adhere strictly to COVID-19 safety operational health protocols established according to Ministry of Health (MOH), Epidemiology Unit. All incoming patients are screened by our nurses as soon as appointments are made over the phone, to understand the nature of their illness. If there is a worry that they could have contracted COVID-19 or have been in contact with such patients, they are given the opportunity to speak to the doctor first over the phone for a detailed history. Every patient will be consulted and no one is turned away from our care.

In order to help patients overcome barriers such as curfews or even the fear of entering communal healthcare settings, our experienced, highly-regarded team of consultants conducts telehealth consultations via established, trusted telemedicine partners such as oDoc and Mydoctor.lk to maintain continuity of care throughout this pandemic. We have also moved many of our long-standing diabetes care and weight management programs online, which have proven to be effective even in the absence of a physical meeting and examination. Additionally, our social media platforms and website are constantly updated to increase awareness about this condition, along with content that informs people about the proper management and prevention of diabetes – particularly when it is thus connected to COVID-19.

 

(Dr. Kayathri Periasamy is a consultant physician MBBS (UK), MRCP (UK), Board Certified in Int. Medicine (U.S.A). She is the founder of Healthy Life Clinic, Colombo 07.)



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Galadari Colombo awarded ‘SLIM People’s Hotel Brand of the Year 2021’

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The Galadari Colombo was given a thumbs up from the people as the People’s Hotel Brand of the Year for the second time running at the recently concluded SLIM (Sri Lanka Institute of Marketing) People’s Awards 2021.

The uniqueness of the SLIM People’s Awards is the fact that it is awarded by the public which shows the popular choice of the Sri Lankan people.

This is the 15th successful running of the much-anticipated event conducted by SLIM in association with Nielsen which is globally renowned for its measurement and consumer insights.

Having stood the test time of time in the hospitality industry for more than 3 decades the Galadari Colombo is hopeful to remain in the hearts of its people as a brand that is trustworthy and dedicated to service.

 

 

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Expatriates’ organization painting competition for Sri Lankan children from care homes highlights close India-Sri Lanka ties

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Celebrating 75 years of India’s independence in Sri Lanka, Sri Lankan children from care homes converged in Colombo from all across Sri Lanka over 10-11 April 2021 for the final round of the nationwide painting competition organized by Colombo Expatriates Cultural Association (CECA) – a voluntary organization of expatriates consisting of mainly Indians – with support of the High Commission of India, Ministry of Education of government of Sri Lanka and several other partners.

Prof. G.L Peiris, Minister of Education was the Chief Guest and Gopal Baglay, High Commissioner of India was the Guest of Honour at the final round. Several other dignitaries including State Minister Piyal Nishantha were also present. The dignitaries lauded the effort as a shining example of strong people-to-people ties between India and Sri Lanka and stressed the enormous significance of the enriching experience for the children.

The competition was held in three categories – Sub Junior, Junior and Senior. The first round of the competition had seen enthusiastic participation of 4,375 students from child care homes across Sri Lanka. Contestants from all provinces who had produced sixty best paintings were invited along with one care-giver for the final round held in Colombo on April 10 at Hotel Taj Samudra. While top three winners in all the three categories were awarded SLR 100,000, SLR 75,000 and SLR 50,000 respectively in addition to various other gifts, certificates and medals, all the 60 finalists received cash awards, desktop computers, and other gifts contributed by various sponsors.

The event also formed part of ‘India @ 75’ celebrations in Sri Lanka which comprise events and activities in the run up to completion of 75 years of India’s Independence in August 2022. Prime Minister of India Shri Narendra Modi had launched these celebrations in India on March 12 2021, 75 weeks before the 75th Anniversary of Independence. In Sri Lanka, formal launch of these celebrations had taken place on April 9 2021 with the inauguration of ‘India Corner’ at the Nagananda Institute for Buddhist Studies.

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Chrissworld to raise Rs. 56.25 million through IPO

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By Hiran H.Senewiratne 

Chrissworld Ltd. (CWL), an SME company  engaged in the provision of third-party logistics (3PL) services, is gearing to raise up to Rs. 56.25 million via an initial public offering (IPO) on the Colombo Stock Exchange, sources said.

The company plans to offer 7,500,000 Ordinary Voting Shares for subscription at Rs. 7.50 per share. The subscription will open on April 27, with Atara Capital Partners representing the company as managers to the issue.

Meanwhile, the CSE noted in a statement that it has approved an application submitted by Chrissworld Ltd. for the listing of its Ordinary Voting Shares by way of an offer for subscription on the Empower Board of the CSE.

The company,  starting off with Rs. 6 million capital in 2019, expanded its capital to Rs. 22.5 million and projects to obtain Rs. 79 million after the IPO.

Chrissworld will be earmarking milestones with the IPO as the first to be listed on the Empower Board, CSE’s newest listing platform, dedicated to SMEs. Further, Central Depository Systems (Pvt.) Ltd., a subsidiary company of CSE, will step in for the first time as the registrar to the issue.

Amid those developments the CSE  started  on a bullish note yesterday and during the latter part of the day with heavy retail investor participation the CSE witnessed a bullish trend. It is said that manufacturing sector counters became the most popular stocks during the day. Notable price appreciation was reported in Hayleys Group, Royal Ceramic Group and  Distilleries.    

Both indices moved upwards. The All Share Price Index went up by 100.10 points and S and P SL20 rose by 49.18 points. Turnover stood at Rs. 3.51 billion with a crossing. The crossing was reported in JKH, which crossed 1.32 million shares to the tune of Rs. 199.3 million and its share price was Rs. 151.

In the retail market, companies that mainly contributed to the turnover were; Royal Ceramic Rs. 511.2 million (1.46 million shares traded), Expolanka Holdings Rs. 359.9 million (4.5 million shares traded),  Hayleys Group Rs. 359.9 million (4.5 million shares traded), Dipped Products Rs. 321 million (5.5 million shares traded), JKH Rs. 290 million (1.9 million shares traded), and Haycarb Rs. 177 million (1.5 million shares traded). During the day 87.8 million share volumes changed hands in 23900 transactions.

Hayleys shares appreciated by Rs. 6 or eight percent. Its shares started trading at Rs. 75.90 and at the end of the day they moved to Rs. 82. Royal Ceramic shares appreciated by Rs. 13.5 or nine percent. Its shares started trading at Rs. 328.25 and at the end of the day they moved to Rs. 358.75. Expolanka shares appreciated by Rs. 2.70 or five percent. Its shares  started trading at Rs. 49.70 and at the end of the day they shot up to Rs. 52.40 and Distilleries shares appreciated by 70 cent or 3 percent from Rs. 20.20 to Rs. 20.90  

Sri Lanka’s rupee quoted steady at 202.00/203 to the one month US dollar Monday, while gilt yields remained unchanged, dealers said.

The rupee last closed in the one-week forward market at 202/203 to the US dollar on Friday. Sri Lanka markets were dull as seasonal bliss kicks in.

 

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